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Pregnancy: Should I Have Amniocentesis?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Amniocentesis is a test to look at the
amniotic fluid that surrounds your baby. This fluid
has cells and other substances in it that can give clues about your baby's
health.

During the test, your doctor puts a needle through your
belly into your
uterus. He or she takes out about
2 Tbsp (30 mL) of amniotic
fluid to send to a lab. The cells in the fluid are checked to see if your baby
has any signs of a serious health problem.

Amniocentesis is
usually done between weeks 15 and 20 of a woman's pregnancy to check for
certain health problems. It's not a routine test. But your doctor may recommend
it if a
fetal ultrasound and blood tests suggest that your
chances of having a baby with a
genetic disorder or a birth defect are higher than
average. Or you may already know that your chances are higher because of your
age and family history.

Some women don't want to wait until their
second trimester to see if their baby might have a problem. They might decide
to have a chorionic villus sampling (CVS) test instead of amniocentesis. CVS
can be done between 10 and 12 weeks of pregnancy to look for Down syndrome and
other serious health problems. But it can't find certain problems, such as
birth defects of the heart, stomach,
intestines, or brain and spine (neural tube defect).

Amniocentesis
may also be done during the third trimester of pregnancy to see if your baby's
lungs are fully formed. This test may be recommended if you need to deliver
early because of a problem with your pregnancy. The test may also be done to
check the amniotic fluid for infection.

When amniocentesis is done during your third trimester, it
can tell you if your baby's lungs are fully formed. The test can also show
whether there is an infection in the amniotic fluid.

Even if the
results from your amniocentesis are normal, it doesn't guarantee that your baby
will be born healthy. For example, this test can't find many common birth
defects, such as
cleft lip,
cleft palate, and heart problems. No single test can
find all problems.

This test can tell you if your baby may be born with a serious health
problem. Many parents are not prepared to care for a baby who is sick or has a
birth defect. Information that you get from this test can help you and your
partner plan for the future.

If the test finds that your baby has
a genetic disorder or a birth defect, you and your partner may be faced with a
tough decision about whether to continue the pregnancy. You may find it helpful
to talk with your doctor and a
genetic counselor. They can help you understand your
baby's health problem and what to expect when he or she is born.

Results from the test can also help you decide where to have your baby.
If your baby will need surgery or special care, you can plan to have your baby
in a hospital that has special services for newborns, such as a neonatal
intensive care unit.

Amniocentesis is usually very safe. But the test does have some risks.
You'll have to weigh the risks against the benefits of knowing if something
might be wrong with your baby.

There is a chance that the test may
cause you to have a
miscarriage. This means that you could lose your baby
after you have the test. But when the test is done by highly trained doctors,
the risk of having a miscarriage is small.

In one study of women who had amniocentesis
performed by a highly trained doctor, about 1 out of 400 women had a
miscarriage after the test. This means that 399 did not.footnote 1

Another study showed that 2 to 4 out of 400 women
had a miscarriage after the test. This means that 396 to 398 did not. This greater risk
may be more likely in medical centers whose doctors have less experience in
doing the test.footnote 2

Other risks include:

Infection. There is a
very small chance that the amniotic fluid may get infected.footnote 3

Injury. There is a chance
that your baby may be poked by the needle during the test. But this is rare
when ultrasound is used to guide the needle. The most common injury is a tear
in the
placenta. This usually heals without a
problem.

Bleeding. There is a small chance
that you could bleed during the test. If this happens, your blood may mix with
your baby's blood. This is only a problem if your blood is Rh-negative and your
baby's is Rh-positive, because you could have an immune system response called
Rh sensitization. If you're at risk for Rh
sensitization, you'll be given a vaccine to prevent it.

Foot defect. There is an increased risk that your baby may be born with a
clubfoot when amniocentesis is done before 15 weeks of
pregnancy.

Your age. As you get older, you have a greater chance of
having a baby with a birth defect.

Your need to know about any problems with your
baby.

What you might do if the test shows a
problem.

Whether you can afford to pay for the test. Amniocentesis
can cost a lot. Most insurance companies will cover the cost of the test if you
have certain risk factors that may increase your baby's chance of having a
serious health problem. A risk factor is something—such as your age or family
history—that raises your risk of having a certain health problem.

Other tests suggest that your chance of
having a baby with a genetic disorder or birth defect is higher than
average.

You or your partner has a family history of birth
defects.

You or your partner carries an abnormal gene that is known
to cause a certain disease.

You want to know if your baby has a serious health problem so
you can decide early whether you want to continue your pregnancy or make plans
to care for a sick child.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Have amniocentesis
Have amniocentesis

You lie on your back while
your doctor puts a long needle into your belly.

You may feel some
discomfort, but the test only takes a few minutes.

You go home
after the test.

You find out early in your
pregnancy if your baby has a genetic disorder or birth
defect.

Information from the test can help you to:

Decide if you want to continue your
pregnancy.

Make plans to care for a baby who is sick or has a birth
defect.

Choose a hospital that specializes in caring for newborns
with serious health problems.

Possible risks
include:

A
miscarriage.

An infection.

A
needle injury to your baby.

Bleeding.

A foot
defect.

Don't have amniocentesis
Don't have amniocentesis

You have regular
prenatal exams and blood tests to check for any signs of problems.

You avoid the cost of
amniocentesis.

You avoid the risks of having amniocentesis.

You won't
know if your baby has a severe birth defect until after he or she is
born.

Birth could be harder on you or your baby if the doctor doesn't know
ahead of time that there is a problem.

Personal stories about considering amniocentesis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I have a
friend whose child was born with Down syndrome. She didn't know about her
baby's Down syndrome until after he was born, and it was emotionally difficult
for her to deal with the diagnosis. I remember how hard it was for her and her
family to adjust to a new life with a special-needs child. I want to know
before giving birth if I am going to have a child with a disability. This will
give me time to prepare emotionally as well as time to prepare to have my baby
at a hospital that is equipped to care for sick babies.

Darla, age 35

I am
prepared to accept my child, regardless of whether he or she has a birth
defect, even a severe birth defect. Even though I am at a higher risk of having
a child with a birth defect because of my age, I will continue the pregnancy
regardless of the results of an amniocentesis. My doctor and hospital are well
equipped to handle my pregnancy and delivery, so I feel that I have made the
best decision for my family and me.

Sarah, age 39

I have no
family history of birth defects. But I am 42 years old, which puts me at
higher risk for having a baby with a birth defect. I have two children already,
and I feel that my time, energy, and financial resources are at a premium. I
can't afford, financially or emotionally, to have a child with a serious birth
defect. I am choosing to have an amniocentesis to help detect a birth defect.
If the results are abnormal, I feel it is in my best interest (and my family's)
to end this pregnancy.

Ana, age 42

I was 35 when I became pregnant with my
first child. I was nervous about pregnancy anyway and especially worried that
there might be something wrong with the baby. I decided to have chorionic
villus sampling instead of waiting for an amniocentesis because it allowed me
to find out in the first trimester if the baby had genetic problems. If the
answer had been yes, I would have terminated the pregnancy. In my case, the
answer was negative, and I was able to go through the rest of my pregnancy
feeling more at ease.

Liza, age 45

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have amniocentesis

Reasons not to have amniocentesis

I'm worried that something might be wrong with my baby.

I'm not worried that something might be wrong with my baby.

More important

Equally important

More important

I want to know if my baby has a birth defect so I have time to prepare to care for a child with special needs.

Knowing that my baby has a birth defect won't change the way I plan to care for my child.

More important

Equally important

More important

I want to know if my baby has a birth defect so I have time to decide if I want to continue my pregnancy.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Pregnancy: Should I Have Amniocentesis?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Have an amniocentesis test.

Don't have amniocentesis.

Key points to remember

Your doctor may recommend amniocentesis if your chances of
having a baby with a genetic disorder or birth defect are higher than
average.

Even though amniocentesis can detect certain problems, it
can't guarantee that your baby will be born healthy. No test can do
that.

If the test shows that your baby may be born with a serious
problem, you and your partner can use the information to plan for the
future.

Amniocentesis is usually very safe. But it does have some
risks, including a small chance of causing a
miscarriage.

FAQs

What is amniocentesis?

Amniocentesis is a test to look at the
amniotic fluid that surrounds your baby. This fluid
has cells and other substances in it that can give clues about your baby's
health.

During the test, your doctor puts a needle through your
belly into your
uterus. He or she takes out about
2 Tbsp (30 mL) of amniotic
fluid to send to a lab. The cells in the fluid are checked to see if your baby
has any signs of a serious health problem.

When is amniocentesis done?

Amniocentesis is
usually done between weeks 15 and 20 of a woman's pregnancy to check for
certain health problems. It's not a routine test. But your doctor may recommend
it if a
fetal ultrasound and blood tests suggest that your
chances of having a baby with a
genetic disorder or a birth defect are higher than
average. Or you may already know that your chances are higher because of your
age and family history.

Some women don't want to wait until their
second trimester to see if their baby might have a problem. They might decide
to have a chorionic villus sampling (CVS) test instead of amniocentesis. CVS
can be done between 10 and 12 weeks of pregnancy to look for Down syndrome and
other serious health problems. But it can't find certain problems, such as
birth defects of the heart, stomach,
intestines, or brain and spine (neural tube defect).

Amniocentesis
may also be done during the third trimester of pregnancy to see if your baby's
lungs are fully formed. This test may be recommended if you need to deliver
early because of a problem with your pregnancy. The test may also be done to
check the amniotic fluid for infection.

When amniocentesis is done during your third trimester, it
can tell you if your baby's lungs are fully formed. The test can also show
whether there is an infection in the amniotic fluid.

Even if the
results from your amniocentesis are normal, it doesn't guarantee that your baby
will be born healthy. For example, this test can't find many common birth
defects, such as
cleft lip,
cleft palate, and heart problems. No single test can
find all problems.

What are the benefits of having amniocentesis?

This test can tell you if your baby may be born with a serious health
problem. Many parents are not prepared to care for a baby who is sick or has a
birth defect. Information that you get from this test can help you and your
partner plan for the future.

If the test finds that your baby has
a genetic disorder or a birth defect, you and your partner may be faced with a
tough decision about whether to continue the pregnancy. You may find it helpful
to talk with your doctor and a
genetic counselor. They can help you understand your
baby's health problem and what to expect when he or she is born.

Results from the test can also help you decide where to have your baby.
If your baby will need surgery or special care, you can plan to have your baby
in a hospital that has special services for newborns, such as a neonatal
intensive care unit.

What are the risks of having amniocentesis?

Amniocentesis is usually very safe. But the test does have some risks.
You'll have to weigh the risks against the benefits of knowing if something
might be wrong with your baby.

There is a chance that the test may
cause you to have a
miscarriage. This means that you could lose your baby
after you have the test. But when the test is done by highly trained doctors,
the risk of having a miscarriage is small.

In one study of women who had amniocentesis
performed by a highly trained doctor, about 1 out of 400 women had a
miscarriage after the test. This means that 399 did not.1

Another study showed that 2 to 4 out of 400 women
had a miscarriage after the test. This means that 396 to 398 did not. This greater risk
may be more likely in medical centers whose doctors have less experience in
doing the test.2

Other risks include:

Infection. There is a
very small chance that the amniotic fluid may get infected.3

Injury. There is a chance
that your baby may be poked by the needle during the test. But this is rare
when ultrasound is used to guide the needle. The most common injury is a tear
in the
placenta. This usually heals without a
problem.

Bleeding. There is a small chance
that you could bleed during the test. If this happens, your blood may mix with
your baby's blood. This is only a problem if your blood is Rh-negative and your
baby's is Rh-positive, because you could have an immune system response called
Rh sensitization. If you're at risk for Rh
sensitization, you'll be given a vaccine to prevent it.

Foot defect. There is an increased risk that your baby may be born with a
clubfoot when amniocentesis is done before 15 weeks of
pregnancy.

What should you think about before you have amniocentesis?

All patient decisions are personal. You might
think about:

Your chance of passing on a family disease to
your baby.

Your age. As you get older, you have a greater chance of
having a baby with a birth defect.

Your need to know about any problems with your
baby.

What you might do if the test shows a
problem.

Whether you can afford to pay for the test. Amniocentesis
can cost a lot. Most insurance companies will cover the cost of the test if you
have certain risk factors that may increase your baby's chance of having a
serious health problem. A risk factor is something—such as your age or family
history—that raises your risk of having a certain health problem.

Why might your doctor recommend amniocentesis?

Your doctor may advise you to have amniocentesis if:

Other tests suggest that your chance of
having a baby with a genetic disorder or birth defect is higher than
average.

You or your partner has a family history of birth
defects.

You or your partner carries an abnormal gene that is known
to cause a certain disease.

You want to know if your baby has a serious health problem so
you can decide early whether you want to continue your pregnancy or make plans
to care for a sick child.

2. Compare your options

Have amniocentesis

Don't have amniocentesis

What is usually involved?

You lie on your back while
your doctor puts a long needle into your belly.

You may feel some
discomfort, but the test only takes a few minutes.

You go home
after the test.

You have regular
prenatal exams and blood tests to check for any signs of problems.

What are the benefits?

You find out early in your
pregnancy if your baby has a genetic disorder or birth
defect.

Information from the test can help you to:

Decide if you want to continue your
pregnancy.

Make plans to care for a baby who is sick or has a birth
defect.

Choose a hospital that specializes in caring for newborns
with serious health problems.

You avoid the cost of
amniocentesis.

You avoid the risks of having amniocentesis.

What are the risks and side effects?

Possible risks
include:

A
miscarriage.

An infection.

A
needle injury to your baby.

Bleeding.

A foot
defect.

You won't
know if your baby has a severe birth defect until after he or she is
born.

Birth could be harder on you or your baby if the doctor doesn't know
ahead of time that there is a problem.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about considering amniocentesis

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I have a friend whose child was born with Down syndrome. She didn't know about her baby's Down syndrome until after he was born, and it was emotionally difficult for her to deal with the diagnosis. I remember how hard it was for her and her family to adjust to a new life with a special-needs child. I want to know before giving birth if I am going to have a child with a disability. This will give me time to prepare emotionally as well as time to prepare to have my baby at a hospital that is equipped to care for sick babies."

— Darla, age 35

"I am prepared to accept my child, regardless of whether he or she has a birth defect, even a severe birth defect. Even though I am at a higher risk of having a child with a birth defect because of my age, I will continue the pregnancy regardless of the results of an amniocentesis. My doctor and hospital are well equipped to handle my pregnancy and delivery, so I feel that I have made the best decision for my family and me."

— Sarah, age 39

"I have no family history of birth defects. But I am 42 years old, which puts me at higher risk for having a baby with a birth defect. I have two children already, and I feel that my time, energy, and financial resources are at a premium. I can't afford, financially or emotionally, to have a child with a serious birth defect. I am choosing to have an amniocentesis to help detect a birth defect. If the results are abnormal, I feel it is in my best interest (and my family's) to end this pregnancy."

— Ana, age 42

"I was 35 when I became pregnant with my first child. I was nervous about pregnancy anyway and especially worried that there might be something wrong with the baby. I decided to have chorionic villus sampling instead of waiting for an amniocentesis because it allowed me to find out in the first trimester if the baby had genetic problems. If the answer had been yes, I would have terminated the pregnancy. In my case, the answer was negative, and I was able to go through the rest of my pregnancy feeling more at ease."

— Liza, age 45

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have amniocentesis

Reasons not to have amniocentesis

I'm worried that something might be wrong with my baby.

I'm not worried that something might be wrong with my baby.

More important

Equally important

More important

I want to know if my baby has a birth defect so I have time to prepare to care for a child with special needs.

Knowing that my baby has a birth defect won't change the way I plan to care for my child.

More important

Equally important

More important

I want to know if my baby has a birth defect so I have time to decide if I want to continue my pregnancy.

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